New rule in 2019 will put hospital prices online

INDIANAPOLIS, Ind. – A new federal law will give patients more information about prices and fees when paying a doctor's visit. The new requirement goes into effect on January 1 and will require hospitals to list prices for procedures on their websites.

The federal rule was put in place by the U.S. Department of Health & Human Services' Centers for Medicare & Medicaid Services (CMS) to make hospitals more transparent and help give patients more information when deciding on important healthcare decisions.

It's being called the Prospective Payment System rule.

Area hospitals like IU Health and Ascension St. Vincent both said their pricing sites will be up soon.

Though experts who have been keeping tabs on the new requirements have said the numbers listed won't be what Hoosiers should expect to pay.

"This is the sticker price for services and it does not reflect the negotiated price between hospitals and insurers," said Laura McCaffrey, the director of legislative regulations at the Indiana Hospital Association (IHA).

The IHA represents nearly every hospital in Indiana.

Prices soon posted online are prices before insurance and other government assistance programs kick in to help offset costs. The actual price will differ from patient to patient.

"Negotiations are individualized by insurance so people still need to contact their insurer to understand what this means for them," McCaffrey said.

IU Health's senior vice president and chief financial officer Jennifer Alvey said more rules should be in place to help patients better understand the costs.

"To further help patients, the Medicare requirements should involve health insurance companies so that they also have a role in price transparency efforts for consumers," Alvey said in a statement released by the healthcare system.

Kristin Metzel is an independent health insurance agent with IAmerica. She said she understands why the government is putting the new rule in place but isn't sure how helpful it could be and is looking forward to seeing hospitals roll out their pricing.

"There should be transparency but there are just more variables that go into it," said Metzel.

While the new rule is a nationwide requirement, Indiana has had something similar in place for a few years.

In 2015, the IHA went online with mycareinsight.org, a website that allows Hoosiers to compare doctors, prices, and an additional measure that the government has not required quality.

McCaffrey said the site has 100 of the most common inpatient procedures and 50 outpatient procedures that people can research and compare to help make decisions on healthcare services.